Single-Incision Pediatric Endosurgery (SIPES)

Abstract

Most centers advocate laparoscopy in order to minimize the size and the number of skin incisions. Many comparative studies, systematic review, and pooled analysis demonstrate that single-incision laparoscopic surgery (SILS) is comparable to conventional laparoscopic surgery (CLS). However, this review identifies the need for randomized controlled trials to clarify the efficacy of SIPS compared with CLS. SIPES pediatric has gained significant popularity. Longer M OT with SIPES was the main concern in most published series. One study has shown that SIPES in children is safe and feasible when performed by resident doctors in comparison to the fellow. We started SIPES in 2003. It is carried out routinely by trainees and specialists. Interferences and collisions between surgical instruments are worse in SIPES than CLS. These challenges extended the OT. Although the use of flexible laparoscopic instruments instead of straight instruments may overcome these technical difficulties, only straight laparoscopic instruments are currently used in our institution. Our aim is to standardize this approach in pediatric age group. The technique can be imparted satisfactorily to trainees. However, its successful incorporation into surgical training programs will depend on the development of innovative simulation strategies.2 appeared in 1992 with appendectomies [4]. In the same year, D'Alessio described a technique for appendectomy in pediatric patients in which a special port was used at the umbilicus to allow the surgeon to bring the appendix out through the umbilicus to perform an extracorporeal appendectomy [5]. 19% of 166 patients in their series required additional trocars, and 4% required conversion to an open operation. The MOT (MOT) was 35 min with a 7-day return to normal activity, compared with 10 days for those that required additional trocars. SIPES has been introduced in our institute by 2003. Now SIPES is our standard technique for many procedures like cholecystectomy, splenectomy, appendectomy, assisted Mitrofanoff, SIPES hernia repair percutaneous internal ring suturing (PIRS), ovarian cystectomy, and fundoplication since 2011. We have performed around 400 SIPES cases up-to-date.